Background: In patients with a prior uterine septum resection, uterine rupture during pregnancy has been reported with the use of energy sources or when complicated by perforation.
Case: A woman was found to have a uterine abnormality during her first pregnancy. After delivery, a septum was diagnosed and hysteroscopically incised using cold scissors without complication. Follow-up hysterosalpingogram showed a small residual septum. In her subsequent pregnancy, emergency cesarean after fetal bradycardia in early labor showed the placenta and fetus totally exteriorized through a cornua to cornua rupture of the fundus.
Conclusion: Uterine rupture during pregnancy after metroplasty is rare but may occur regardless of the method of metroplasty, absence of complications, or careful follow-up.